title: Sporadic occurrences of fluoroquinolone-resistant Streptococcus pneumoniae in the United States: longitudinal analysis of institutions from the New England and West South Central regions during the TRUST 4-9 (2000-2005) Surveillance Studies.
abstract: Twenty-six institutions in New England and 24 institutions in West South Central regions participating in the Tracking Resistance in the United States Today (TRUST) 4-9 surveillance studies (2000-2005) were monitored for levofloxacin-resistant Streptococcus pneumoniae to determine if resistance was sporadic or persistent. Levofloxacin was used as a representative of the respiratory fluoroquinolones. Levofloxacin-resistant isolates were identified in 8 of the 26 New England institutions and in 11 of the 24 West South Central institutions during the surveillance period. Resistant isolates were recovered in consecutive years from 3 institutions: 1 each in Massachusetts, Oklahoma, and Texas. In total, 34 levofloxacin-resistant isolates (14 from New England, 20 from the West South Central region) were identified over the 6-year period. Two of these isolates from an institution in Connecticut and 2 from an institution in Oklahoma had the same serotype, pulsed-field gel electrophoresis pattern, and quinolone resistance-determining region (QRDR) mutations. States with elevated pneumococcal levofloxacin resistance rates, compared with the national average, did not maintain this status in consecutive years. Based on data from the same institutions over 6 years, levofloxacin resistance among US pneumococci has been sporadic, nonclonal, and rare.
authors.affiliation: Johnson and Johnson Pharmaceutical Research and Development LLC, Raritan, NJ 08869, USA. tdavies@prdus.jnj.com
authors.forename: Todd A
authors.initials: TA
authors.lastname: Davies
authors.forename: Y Cheung
authors.initials: YC
authors.lastname: Yee
authors.forename: Karen
authors.initials: K
authors.lastname: Amsler
authors.forename: Raul
authors.initials: R
authors.lastname: Goldschmidt
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Sahm
authors.forename: Alan T
authors.initials: AT
authors.lastname: Evangelista
mesh_terms: D024881:Drug Resistance, Bacterial; D024841:Fluoroquinolones; D006801:Humans; D008137:Longitudinal Studies; D008826:Microbial Sensitivity Tests; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D011159:Population Surveillance; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000382:microbiology*; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D014481:United States / Q000453:epidemiology
chemical_list: D024841:Fluoroquinolones